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Mercer

Today is the seven-year anniversary of the signing of the ACA, and we spent it with our eyes glued on the House, waiting for a vote to repeal the law. It looks like the vote is delayed, so too soon to call if it’s lucky number seven for the Republicans or the Democrats. 

 

 

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What happens to the ACA has serious implications for employers. In response to the recent introduction of the American Health Care Act, which seeks to repeal much of the ACA and replace it with new policies, we’ve prepared a very brief survey to gauge employer response and ensure your voice is heard. 

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This has been a busy week for healthcare in DC -- and the week’s not over yet! On the heels of the leaked Republican reconciliation bill language last Friday (that is already being described as out of date), the governors arrived over the weekend for a National Governors Association meeting that included dinner at the White House on Sunday. While the President tweeted that they “might” talk about healthcare, you can be sure the future of the Medicaid program and, more specifically, Medicaid funding, was at the top of the governors’ list of topics. Certainly, the 31 states that expanded Medicaid fear the funding implications of a block-grant program.

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Final Department of Labor (DOL) rules require ERISA plans processing disability claims to treat coverage rescissions like benefit denials, impose more detailed denial notices written in a "culturally and linguistically appropriate manner," and expand claimants' response and litigation rights. The new rules generally apply for claims filed on or after Jan. 1, 2018, but transitional notice requirements apply for claims filed from Jan. 18, 2017 -- the final regulations' effective date -- through Dec. 31, 2017. While the new administration or Congress might delay, change, or even try to overturn the disability regulations, employers should still plan their next steps as the rules may remain intact.

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When your boss asks about how the election will affect your benefit program, your response could be as easy as "It all depends." But you might want to provide more of an answer, and if so we'd like to help you out.

 

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Congress has passed legislation to increase enforcement of mental health and substance abuse parity rules and require health plans to apply parity standards to eating disorder benefits as part of a sweeping bill intended to spur development of new drugs and medical devices. The 21st Century Cures Act also includes provisions to let small employers use health reimbursement accounts (HRAs) to cover employees' costs for individual-market health insurance on a tax-free basis. The measure is expected to be signed into law by President Obama.

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Signaling that he is serious about rolling back the ACA, President-elect Donald Trump has chosen Rep. Tom Price (R-Ga.), one of Capitol Hill's fiercest critics of President Obama's health care law, to be Secretary of Health and Human Services. Price, an orthopedic surgeon and Chair of the House Budget Committee, is the author of one of the Republican ACA replacement plans, Empowering Patients First, which you can read about here.

 

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The new Mercer Survey on Absence and Disability Management found that employers continue to embrace workplace flexibility, in part demonstrated by a migration from traditional vacation/sick plans to paid time off (PTO plans). PTO plans are now in place in 63% of the organizations surveyed, up from 50% in 2013 and 38% in 2010. PTO plans provide employees more flexibility and reduce the need to determine (and track) what type of day off is being taken.

 

But despite their focus on time off, many employees do not use all of the days available to them: 44% of participants report that their employees take less than 80% of their allotted PTO time. And for the growing number of employees who work remotely, time off may not truly be time away from work. Employers are rethinking time-off program design to take into account all of these dynamics and help employees to achieve a healthier work/life balance.

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You remember the old algebra formulas from school: 3X + 2 = 11. Solve for X.

 

 

Now you’re solving problems in the business world. If you’re in charge of health benefits, solving for “X” means: Solve for lower premiums. Solve for more choice. Solve for higher quality, more efficiency, and better adherence.

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With the election behind us, the news is full of speculation about what will happen next. We hosted a webcast for employers two days after the election and had a record turnout, taking the opportunity to conduct a quick opinion poll about repealing and replacing the ACA and other possible legislative actions by the new president and the 115th Congress.

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Your new employee is 26 years old. He’s rarely sick -- maybe some occasional weekend-warrior soreness. His biggest health expense is his refrigerator full of grape Mountain Dew Kickstarts.

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Here’s an employee advocating for her own health: Before a medical appointment, she checks her health insurance to make sure the visit is covered. During the visit, she takes notes. Before the doctor writes the prescription, she asks, “Are there any generics?”

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